Nokea
Toxic shock syndrome:
- A. will often manifest without fever
- B. is a misnomer because BP is often maintained
- C. is caused by pseudomonas species
- D. often produces elevated creatinine kinase
Correct Answer: D
Rationale: TSS fever burns, BP drops, staph rules, CK jumps, rash spreads. Nurses clock this chronic toxin surge.
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During artificial ventilation in a patient with chronic obstructive pulmonary disease, air trapping:
- A. Leads to hypotension when venous return is reduced significantly.
- B. Is likely to be present when the capnogram fails to reach a plateau in expiration.
- C. May be reduced by using a low respiratory rate.
- D. Is reduced by decreasing the ratio of inspiratory time to expiratory time.
Correct Answer: A
Rationale: Air trapping in COPD during mechanical ventilation occurs due to incomplete exhalation from airway obstruction, leading to intrinsic positive end-expiratory pressure (auto-PEEP). This increases intrathoracic pressure, compressing the vena cava and reducing venous return, which can cause hypotension a critical complication. A capnogram failing to plateau suggests prolonged exhalation, consistent with air trapping, but it's a diagnostic sign, not a consequence. A low respiratory rate allows more exhalation time, reducing air trapping, while decreasing the inspiratory-to-expiratory time ratio (e.g., shortening inspiration) similarly helps by extending exhalation. Positive end-expiratory pressure (PEEP) can exacerbate air trapping if excessive, but its effect depends on levels used. Hypotension from reduced venous return is a direct physiological result of severe air trapping, making it the most definitive statement in this context.
The following are true about education for insulin therapy EXCEPT:
- A. It can only be done by nurses
- B. Different subjects to be covered at different stages of insulin therapy
- C. Improves adherence to insulin therapy
- D. It takes time
Correct Answer: A
Rationale: Insulin teaching docs, educators join nurses, staged topics boost sticking, time and prep pay off; nurse-only's bunk. Nurses weave this chronic learning web, not solo.
The nurse receives change-of-shift report on the oncology unit. Which patient should the nurse assess first?
- A. A 35-yr-old patient who has wet desquamation associated with abdominal radiation
- B. A 42-yr-old patient who is sobbing after receiving a new diagnosis of ovarian cancer
- C. A 24-yr-old patient who received neck radiation and has blood oozing from the neck
- D. A 56-yr-old patient who developed a new pericardial friction rub after chest radiation
Correct Answer: C
Rationale: Neck oozing post-radiation flags carotid rupture a bleed-out risk trumping wet skin , sobs , or heart rub (D tamponade's slower). Nurses in oncology bolt here airway and blood loss kill fastest, demanding stat checks.
A nurse is caring for a client who has heart failure and a prescription for digoxin 125 mcg PO daily. Available is digoxin PO 0.25 mg/tablet. How many tablets should the nurse administer per dose?
- A. 0.25
- B. 0.5
- C. 1
- D. 1.5
Correct Answer: B
Rationale: Digoxin math: 125 mcg ordered, 0.25 mg (250 mcg) per tablet 125 ÷ 250 = 0.5 tablets, a precise dose nurses calc to boost heart failure's pump, avoiding toxicity's narrow edge. Wrong cuts (0.25, 1, 1.5) miss the mark. Accuracy here rules, a daily win in this med game.
What is the relationship between hyperlipidaemia and non-alcoholic steatohepatitis (NASH)?
- A. Hyperlipidaemia contributes to the development of NASH
- B. NASH contributes to the development of hyperlipidaemia
- C. There is no relationship between hyperlipidaemia and NASH
- D. Answers 1 and 2 are correct
Correct Answer: D
Rationale: NASH and hyperlipidaemia dance both ways high lipids pile fat, NASH pumps them back, a chronic loop. No split or null fits nurses track this lipid-liver ping-pong.